Optical coherence tomography angiography in intermediate uveitis-related cystoid macular edema

Background: Cystoid macular edema (CME) is the leading cause of permanent visual impairment in patients with uveitis, particularly in patients with intermediate uveitis (IU). This study was aimed at comparing the changes in the macular microvasculature in patients with IU with uveitic non-responsive CME and without macular edema. Methods: In this case-control study, 55 eyes of patients with IU were assessed for macular microvascular structures, including vascular density, foveal avascular zone (FAZ) measurement, and vascular morphological changes, using spectral-domain optical coherence tomography angiography (OCT-A) with the AngioVue OCT-A system. We divided patients into the following two groups: the case group, including 30 eyes with IU-related non-responsive CME, and the control group, including 25 eyes with IU without macular edema. Results: Participants in the case and control groups had comparable age (P = 0.753) and sex (P = 0.124) distributions. Superficial capillary plexus vessel density in the case group was significantly decreased in the whole image (P = 0.027) and the parafoveal area (P  = 0.001) compared to the control group. However, there were no statistically significant differences between the two groups in terms of foveal superficial vessel density, deep capillary plexus vessel density, FAZ area, FAZ perimeter, FAZ acircularity index, or foveal vessel density in a 300-µm-wide annulus around the FAZ (all P > 0.05). Vascular morphological changes, such as the capillary tuft, telangiectatic vessels, or micro-aneurism, were not different in the overview images of the OCT-A printout between the two groups. Conclusions: The mean superficial capillary plexus vessel density was lower in eyes with IU-related nonresponsive CME than in those without macular edema. We observed more cystoid spaces in SCP than in DCP. Microcystic changes in the inner retina and ischemia may be the underlying cause in eyes with nonresponsive CME. Future prospective longitudinal studies with healthy, matched controls are warranted to confirm our findings

Pattern of Uveitis in Iran: A Systematic Review

Purpose: Uveitis is the third leading cause of blindness worldwide. This study aimed to summarize the pattern of uveitis in Iran through a systematic review. Methods: This review was conducted according to the guidelines for systematic reviews in the following four steps: literature search, study selection and assessment, inclusion and exclusion criteria, and statistical analysis. Results: One hundred and fifteen articles were identified by an encyclopedic literature search, and three independent investigators examined them according to the defined inclusion and exclusion criteria. Eventually, 109 manuscripts were retrieved and six cross-sectional studies covering 3,567 patients were included and reviewed. According to the results, the mean age of patients was 40 years, and sex was not a statistically significant predisposing factor. The most common anatomical pattern of involvement was anterior uveitis, and the prevalence of the other three types of uveitis, including middle, posterior, and pan-uveitis, were almost equal. Overall, the most common etiologies of uveitis in the Iranian population were idiopathic uveitis, toxoplasmosis, Behcet’s syndrome, and Fuchs heterochromic iridocyclitis. Conclusion: This study depicted the pattern of uveitis in Iranian society; this can help physicians in the diagnostic approach, management, and treatment of patients

Pattern and Visual Prognostic Factors of Behcet’s Uveitis in Northwest Iran

Purpose: To investigate the pattern of ocular involvement in Behcet’s disease (BD) with predictors of patients’ final state of vision. Methods: This historical cohort encompassed the clinical records of 200 patients diagnosed according to the International Criteria for BD (ICBD), over a period of 17 years between 2004 and 2021. Results: The prevalence of Behcet’s uveitis (BU) was more common in females and patients in the fourth decade of life. Ninety-five patients (47.5%) had evidence of ocular involvement in the initial ophthalmologic evaluation, and 171 patients (85.5%) manifested evidence of BU during the follow-up visits of which bilateral non-granulomatous panuveitis was the most common anatomical pattern of involvement (32.9%) followed by posterior (27.6%), anterior (26.5%), and intermediate (13.8%) uveitis. The prevalent accompanying signs were oral aphthous (67%), skin lesions (29%), and genital ulcers (19.5%). Cystoid macular edema (CME) was the most frequent ocular complication (62%), followed by cataract (57.5%) and epiretinal membranes (ERM) (36.5%). Univariate analysis showed the following determinants: male gender, younger age at onset, panuveitis, posterior uveitis, retinal vasculitis, and longer duration of uveitis as poorer visual prognostic factors of the disease. Multivariate analysis demonstrated a higher chance of poor visual prognosis of BD in patients with panuveitis, posterior uveitis, retinal vasculitis, and longer duration of uveitis. Conclusion: This cohort study demonstrated an overview on epidemiological patterns of BU along with the visual prognostic factors in Iranian patients

Corneal densitometry and its correlation with anterior and posterior elevation in keratoconus

AIM: To evaluate the corneal densitometry in treatment-naive patients with keratoconus and its relevance with anterior and posterior corneal elevation.METHODS: Keratoconic corneas were examined using the Pentacam. Corneal densitometry was measured over a 12-mm diameter area, divided by annular concentric zones and depths, more over anterior and posterior corneal elevation was measured. Keratoconus was classified according to the topographic keratoconus classification.RESULTS: A total of 152 subjects \〖72 patients with keratoconus(46 male, 26 female)and 80 healthy control subjects(50 male,30 female)\〗 were included in the study. There were significant differences in corneal densitometry values of the groups in central 2 mm keratoconus(KC)=19.62±4.17 gray scale unit(GSU), N=15.38±1.54 GSU(PP PP=0.001 and KC=11.40±1.23 GSU, N=12.35±0.88, P=0.002 respectively). Analysis of the correlation between corneal densitometry for each layer depth(anterior, central and posterior)with posterior corneal elevation values demonstrated significant association(r=0.293, r=0.278 and r=0.294 respectively). The similar correlation was not found between corneal densitometry for each layer depth and anterior corneal elevation(r=-0.211, r=-0.101, r=0.99 respectively). In the control patients such a significant correlation between posterior/anterior corneal elevation and corneal light backscatter for each layer depth was not found.CONCLUSION: The densitometry map reveals that light backscatter was higher in the central portion of the anterior keratoconic cornea. Corneal densitometry values of keratoconus patients were correlated with posterior corneal elevation in 0-2, 6-10 and 10-12 annuli and in all anterior, central and posterior layers. The densitometry level was higher in more advanced stages

Pattern and Visual Prognostic Factors of Behcet's Uveitis in Northwest Iran

Purpose: To investigate the pattern of ocular involvement in Behcet's disease (BD) with predictors of patients' final state of vision. Methods: This historical cohort encompassed the clinical records of 200 patients diagnosed according to the International Criteria for BD (ICBD), over a period of 17 years between 2004 and 2021. Results: The prevalence of Behcet's uveitis (BU) was more common in females and patients in the fourth decade of life. Ninety-five patients (47.5%) had evidence of ocular involvement in the initial ophthalmologic evaluation, and 171 patients (85.5%) manifested evidence of BU during the follow-up visits of which bilateral non-granulomatous panuveitis was the most common anatomical pattern of involvement (32.9%) followed by posterior (27.6%), anterior (26.5%), and intermediate (13.8%) uveitis. The prevalent accompanying signs were oral aphthous (67%), skin lesions (29%), and genital ulcers (19.5%). Cystoid macular edema (CME) was the most frequent ocular complication (62%), followed by Cataract (57.5%) and epiretinal membranes (ERM) (36.5%). Univariate analysis showed the following determinants: male gender, younger age at onset, panuveitis, posterior uveitis, retinal vasculitis, and longer duration of uveitis as poorer visual prognostic factors of the disease. Multivariate analysis demonstrated a higher chance of poor visual prognosis of BD in patients with panuveitis, posterior uveitis, retinal vasculitis, and longer duration of uveitis. Conclusion: This cohort study demonstrated an overview on epidemiological patterns of BU along with the visual prognostic factors in Iranian patients